Cancer Alliance Data Pack - PDF Free Download

Surrey and Sussex Cancer Alliance Data Pack By February 18 Version 1.1 Produced by the Cancer Alliance Data, Evidence and Analysis Service (CADEAS) For any enquiries contact: england.cadeas@nhs.net

Contents 1 Summary of key findings 2 About the data pack 3 How to interpret the data 4 Further data releases 5 Alliance key indicators grid 6 Alliance key indicators grid, with values 7 Alliance indicators by Outcome indicators One-year age-standardised net cancer survival Under-75 age-standardised cancer mortality rate Cancer prevalence Patient experience: rating of overall care Pathway indicators Bowel screening uptake and coverage Breast screening uptake and coverage Cervical screening coverage Cancers diagnosed through an emergency presentation Routes to diagnosis: breast, colorectal, lung and prostate cancer Cancer waiting times: two-week wait and 62-day standard Age-standardised cancer incidence rate Cancers diagnosed at stage 1+2 Cancers staged Median waiting times: prostate, colorectal and lung cancer 8 Annex of data sources This data pack uses information provided by patients and collected by the NHS as part of their care and support Version Number Detail Date 1. Initial release 12/2/18 1.1 Text in the pack has been updated to reflect change from internal to public use /11/18 CADEAS Alliance Data Pack by 2

1. Summary of key findings The Surrey and Sussex Cancer Alliance The latest available data on some key cancer indicators suggest the standard of cancer care in the Cancer Alliance was mixed. Guildford and Waverly and Horsham and Mid Sussex s had the most indicators that were better than the England average. In contrast, Brighton and Hove, and North West Surrey s performed worse than the England averages on a number of indicators. Screening: Screening uptake and coverage were generally similar to, or better than, the England average across all s, with the exception of Brighton and Hove, and North West Surrey s who performed below England levels across all screening programmes. Emergency presentations: Emergency presentations were in line with, or better than, the England average in all s except and and Farnham s. Cancer waiting times: Two-week waiting times were exceeded in all s, except in Horsham and Mid Sussex, where it was lower than expected. The 62-day standard was met in four s: Guildford and Waverley, and Farnham, Surrey Downs and s. Early diagnosis: The proportions of cancers diagnosed at an early stage was generally similar to England levels in all but two s ( and and Farnham s). In Horsham and Mid Sussex the proportion of early stage diagnoses was higher than the England average. Survival: One-year survival was mixed in the Alliance with the majority of s reporting better survival outcomes than England levels, with poorer survival in four s (Brighton and Hover,, and Seaford, and Hastings and Rother s). Mortality: Under-75 mortality was similar to, or better than, the England average in all s. Patient experience: Patient reported experience of care was in line with the England level., except in, where it was better. CADEAS Alliance Data Pack by 3

2. About the data pack Cancer Alliances were formed as a result of recommendations in the 15 Independent Cancer Taskforce's Achieving World-Class Cancer Outcomes report. The 19 Alliances lead on the local delivery of the Cancer Strategy Implementation Plan, using a whole pathway and cross-organisational approach. CADEAS is a partnership between NHS England and Public Health England. The service supports Alliances with their data, evidence and analysis needs, to help drive evidencebased local decisions in the delivery of the Cancer Strategy Implementation Plan. This data pack aims to provide all Cancer Alliances in England with a snapshot of cancer in their local populations, with a breakdown by Clinical Commissioning Group (). 3. How to interpret the data This data pack highlights variation in cancer services across s in the Alliance. By using a colour coding system Alliances can identify where variation exists and prioritise areas for action. Data here should be considered alongside other sources of information for contextual and richer interpretation. The colour system: broadly, yellow indicates data are similar to the England level. Dark blue shows data are better than England and light blue indicates data are worse than England. Some metrics have been benchmarked to operational standards or expected values; these are denoted in the legends and in the Annex. All statistical tests for England benchmarking have been conducted using a 95% confidence level. At the time this report was made, there were three sites of the National Cancer Vanguard and 16 Alliances and the metric geography labels reflect this. Information on data sources can be found in the Annex. 4. Data releases CADEAS have released the following products,containing data metrics for the Cancer Alliances: A one-off level data pack for each of the 19 Cancer Alliances, to enable comparisons across s within an Alliance. Indicator summary grids comprising key indicators for each Alliance, available at, STP and Alliance levels. These are similar to the grids found in sections 5 and 6 of this data pack and are published by CADEAS on a monthly basis. CADEAS Alliance Data Pack by 4

One-year cancer survival Under 75 cancer mortality age-standardised rate Patient experience Bowel screening coverage (-69) Bowel screening uptake (-69) Bowel screening coverage (-74) Bowel screening uptake (-74) Breast screening coverage Breast screening uptake Cervical screening coverage Emergency presentations Cancer Waiting Times: Two-Week Wait Cancer Waiting Times: 62-day Standard Incidence age-standardised rate Early stage diagnosis Cancers staged 5. Cancer Alliance key indicators grid, by.5 144.891 8.78 55.1219 54.6746 56.3882 56.98 67.9526 61.3276 68.2 19.57 94.5418 75.848 663.533 49.7947 84.3337 71.8 132.516 8.68714 61.496.6718 63.4542 62.7641 72.299 74.96 74.451 18.36 96.5146 84.8646 643.459 49.6897 87.3766.1 132.387 8.786 53.1849 52.2492 55.6341 55.47 65.42 79.4958 69.7988 24.7525 94.383 81.169 666.4.5435 89.4231 74.1 114.15 8.83334 58.682 57.3785.526 59.9316 71.395.2962 72.9796 18.12 93.2288 84.689 644.332 55.3642 86.39 71 132.84 8.65588 59.7924 57.6381 61.6435.195 71.4392 73.4745 74.5551 19.4379 97.6985 77.8351 595.254 51.8987 83.5468 74.7 6.986 8.65394.6876.58 63.3668 63.3763 73.6285 72.7262 73.1955 17.2273 98.9277 92.4157 5.944 52.8624 77.4278 69.6 141.59 8.66773.6231 58.184 62.1651.2188 73.3435 73.72 74.3757 19.184 95.72 72.54 5.1 49.3684 86.6737 71.7 112.361 8.56333.9844 59.8186 62.8486 62.29 74.15.5856 74.8361 16.2963 94.112 76.8212 566.258 52.1537 86.1461 73.5 1.195 8.57786 63.2246 63.626 65.769 65.3512 77.27 76.5922 76.9242 16.7774 92.7738 82.3841 584.8 56.9144 86.4 75.6 112.452 8.66412 62.2886 62.3371 64.5439 65.1389 72.8647 71.333 75.3347 24.217 96.3248 87.85.386 47.6923 9.1324 74.8 129.187 8.6239 55.943 55.5139 58.2889 58.2316 69.9655 69.9188 71.1193 17.187 94.1948 83.86 577.723 53.11 77.1731 75.3 128.266 8.95972 58.458 57.8841.7866.7923.7992 69.44 72.2638 14.191 96.44 88.85 596.95 54.5171 83.359 76.3 133.558 8.81624.1494 59.47 62.5396 62.945 71.5682.1259 73.3328 22.833 96.375 88.8393 595.615 48.951 9.91 Statistically worse than England Excludes routes to diagnosis, prevalence and pathway median waiting times. This is due to the volume of data in these three areas. Please see data in rest of data pack CADEAS Alliance Data Pack by 5

Rate per, Survival (%) 7. Alliance indicators by Cancer survival One-year index of cancer survival, all cancers, adults diagnosed in 15 and followed up to 16 9 8 71.8 74.1 74.7 71.7 73.5 75.6 74.8 75.3 76.3.5.1 71. 69.6 Statistically worse than England Taskforce Ambition (75% by ) England (72.3%) Cancer mortality Age-standardised mortality rate for all cancers, patients under 75, 15 1 1 1 8 145 133 132 132 114 7 142 112 1 112 129 128 134 Statistically worse than England England (136.6 per, population) CADEAS Alliance Data Pack by 7

< 1 yr 1 yrs - < 2 yrs Cases Crude Rates per, (cases / total population in 15) 2 yrs - < 5 yrs 5 yrs - < yrs yrs - < 15 yrs 9 769 1,885 2,93 1,259 892 3 2 661 734 441 313 2,593 2,73 4,875 5,166 3,296 2,9 524 419 985 1,44 666 446 8 323 662 791 437 358 368 291 597 713 394 323 783 595 1,384 1,548 1,35 745 4 327 7 8 569 9 96 715 1,694 1,99 1,233 789 482 38 91 1,15 656 419 774 627 1,669 1,885 1,177 951 376 4 8 915 571 461 896 721 1,549 1,864 956 686 486 391 8 1,11 518 372 759 9 1,614 1,741 1,54 769 442 355 941 1,15 614 448 944 822 1,898 2, 1,289 995 4 357 824 899 5 432 827 653 1,649 1,877 1,154 781 395 312 788 897 552 373 1,28 1,123 2,6 3,73 1,678 1,1 373 327 789 896 489 8 1,218 1,93 2,473 3,13 2,41 1,498 424 381 862 1, 711 522 383 345 781 955 587 464 3 815 996 612 484 15 yrs - < 21 yrs < 1 yr 1 yrs - < 2 yrs 2 yrs - < 5 yrs 5 yrs - < yrs yrs - < 15 yrs 15 yrs - < 21 yrs Cancer prevalence Patients diagnosed with cancer between 1995-15 (inclusive) alive on the 31st December 15 (21-year prevalence) Number of cases and crude rates are in year bands representing time since diagnosis CADEAS Alliance Data Pack by 8

Average score from very poor () to very good () Cancer patient experience 9 8 7 6 5 4 3 2 1 Patient overall rating of cancer care, case-mix adjusted, 16 8.7 8.7 8.8 8.8 8.7 8.7 8.7 8.6 8.6 8.7 8.6 9. 8.8 Statistically worse than England England (Score: 8.7) CADEAS Alliance Data Pack by 9

Bowel cancer screening, ages -69 % Persons, aged -69, screened for bowel cancer in last months (2.5 year coverage), 16/17 55.1 61.5 58.1 59.8.7.6 61. 53.2 63.2 62.3 55.9 58.5.1 Statistically worse than England England (57.5%) Persons, aged -69, screened for bowel cancer within 6 months of invitation (uptake), 16/17 % 54.7.7 63.1.3 62.3 57.4 57.6 58.2 59.8 55.5 57.9 52.2 59.7 Statistically worse than England England (57.1%) CADEAS Alliance Data Pack by

Bowel cancer screening, ages -74 % Persons, aged -74, screened for bowel cancer in last months (2.5 year coverage), 16/17 63.5 56.4 55.6.1 61.6 63.4 62.2 62.8 65.1 64.5 58.3.8 62.5 Statistically worse than England England (59.2%) Persons, aged -74, screened for bowel cancer within 6 months of invitation (uptake), 16/17 62.8 56.4 55.6 59.9.2 63.4.2 62.3 65.4 65.1 58.2.8 62.9 % Statistically worse than England England (59%) CADEAS Alliance Data Pack by 11

Breast cancer screening % 9 8 Females, aged -, screened for breast cancer in last 36 months (3 year coverage), 16/17 72.3 73.6 73.3 74.2 77.3 72.9 68. 71.4 71.4..8 71.6 65.5 Statistically worse than England England (72.5%) % 9 8 61.3 Females, aged -, screened for breast cancer within 6 months of invitation (uptake), 16/17 74.9 79.5.3 76.6 73.5 72.7 73.3 71..6 69.9 69.4.1 Statistically worse than England England (72.2%) CADEAS Alliance Data Pack by 12

Emergency Presentation (%) Cervical cancer screening Females, aged 25-64, attending cervical screening within target period (3.5 or 5.5 year coverage), 16/17 % 9 8 74. 73. 74.6 73.2 74.4 74.8 76.9 75.3 72.3 73.3 68.5 69.8 71.1 Statistically worse than England England (72.1%) Emergency presentations Cancers diagnosed through emergency presentation, year to June 17 25 15 19.5 24.8 18.4 18.1 19.4 17.2 19.2 24. 16.3 16.8 17. 14.2 22.8 5 Statistically worse than England England (19.4%) CADEAS Alliance Data Pack by 13

Routes to diagnosis Routes to diagnosis for breast cancer in England, 6-15 Screen Detected Managed Emergency Presentation Other Number of Cases 24% 63% 5% 8% 1,875 27% 61% 4% 9% 5,145 28% 61% 4% 8% 763 31% 55% 3% 11% 1,485 28% % 5% 7% 1,825 % 49% 5% 16% 1,777 27% 63% 5% 5% 1,83 29% 57% 4% 9% 1,672 26% % 4% 11% 1,939 24% 54% 4% 19% 1,565 28% 56% 4% 13% 2,791 % 54% 3% 12% 2,594 27% 55% 3% 15% 791 Routes to diagnosis for colorectal cancer in England, 6-15 Screen Detected Managed Emergency Presentation Other Number of Cases 5% 44% 28% 23% 1,431 7% 57% 22% 14% 4,43 6% 54% 22% 18% 562 7% 51% 21% 21% 1,134 6% 61% 22% 12% 1,646 8% 54% 21% 17% 1,166 6% 55% 29% 11% 1,544 6% % 25% 19% 1,181 7% 48% 22% 22% 1,383 8% 52% % % 1,225 7% 49% 26% 18% 2,256 6% 53% 22% 19% 1,867 9% 48% 23% % 571 Statistically worse than England CADEAS Alliance Data Pack by 14

Routes to diagnosis Routes to diagnosis for lung cancer in England, 6-15 Managed Emergency Presentation Other Number of Cases 49% 36% 15% 1,515 55% 32% 13% 3,548 41% 45% 14% 556 41% 43% 16% 938 54% 34% 13% 1,368 % 35% 16% 786 49% 39% 12% 1,464 % 34% 16% 914 45% 38% 17% 1,1 29% 33% 39% 1,57 48% 34% 18% 1,895 47% 37% 16% 1,545 32% 33% 35% 482 Routes to diagnosis for prostate cancer in England, 6-15 Managed Emergency Presentation Other Number of Cases 77% % 13% 1,572 81% 6% 13% 4,695 79% 8% 13% 572 73% 9% 18% 1,215 77% % 13% 1,2 76% 7% 18% 1,7 8% % % 1,557 77% 9% 13% 1,1 76% 8% 16% 1,7 69% 6% 24% 1,272 % 12% 18% 2,275 69% 9% 22% 2,251 % 7% 24% 679 Statistically worse than England CADEAS Alliance Data Pack by 15

Total Seen Q3: Oct-Dec 16/17 Q4: Jan-Mar 16/17 Q1: Apr-Jun 17/18 Q2: Jul-Sep 17/18 Seen After 14 Days Seen Within 14 Days Total Seen Seen After 14 Days Seen Within 14 Days Total Seen Seen After 14 Days Seen Within 14 Days Total Seen Seen After 14 Days Seen Within 14 Days 2,839 147 95% 2,84 183 93% 2,984 161 95% 2,952 141 95% 4,9 133 97% 4,293 125 97% 4,618 2 96% 4,6 174 96% 1,48 43 96% 1,135 51 96% 1,136 68 94% 1,114 87 92% 1,522 75 95% 1,529 85 94% 1,6 122 93% 1,758 154 91% 2,133 29 99% 2, 25 99% 2,3 62 97% 2,254 84 96% 1,321 3 % 1,133 21 98% 1,165 18 98% 1,137 9 99% 1,959 57 97% 1,874 65 97% 1,938 95% 1,889 2 95% 1,764 92 95% 1,743 95 95% 1,923 128 93% 1,839 113 94% 2,353 151 94% 2,3 176 92% 2,182 1 93% 2,337 186 92% 1,7 45 97% 1,3 42 97% 1,357 48 96% 1,359 61 96% 2,1 99 96% 2,712 178 93% 2,949 161 95% 2,921 217 93% 2,388 73 97% 2, 58 97% 2,6 5 95% 2,615 7 96% 744 34 95% 623 22 96% 633 97% 776 34 96% Cancer waiting times: two-week wait Two-week wait for all cancers, year to Sep 17 CADEAS Alliance Data Pack by 16

Total Seen Q3: Oct-Dec 16/17 Q4: Jan-Mar 16/17 Q1: Apr-Jun 17/18 Q2: Jul-Sep 17/18 Seen After 62 Days Treated Within 62 Days Total Seen Seen After 62 Days Treated Within 62 Days Total Seen Seen After 62 Days Treated Within 62 Days Total Seen Seen After 62 Days Treated Within 62 Days 176 44 75% 2 51 76% 164 37 77% 187 46 75% 471 74 84% 1 74 85% 429 54 87% 482 83 83% 64 11 83% 69 12 83% 82 16 8% 8 17 79% 2 17 83% 4 16 85% 132 23 83% 132 16 88% 178 83% 198 49 75% 184 78% 216 53 75% 95 8 92% 86 7 92% 97 3 97% 78 9 88% 177 46 74% 164 % 152 52 66% 175 37 79% 146 35 76% 169 38 78% 149 31 79% 1 36 74% 179 31 83% 6 81% 177 83% 193 32 83% 4 18 83% 122 13 89% 121 18 85% 121 8 93% 228 35 85% 226 43 81% 223 36 84% 9 33 84% 7 9% 193 21 89% 169 88% 192 24 88% 57 8 86% 6 88% 54 8 85% 63 3 95% Cancer waiting times: 62-day standard 62-day standard for all cancers, year to Sep 17 CADEAS Alliance Data Pack by 17

Patients seen within 62 days (%) Patients seen within 14 days (%) Cancer waiting times: two-week wait 9 8 Two-Week Wait for all cancers, year to Sep 17 94.5 96.5 97.7 98.9 94.4 93.2 95.8 94.1 96.3 92.8 94.2 96.4 96. Same as operational standard Below operational standard Above operational standard England (94.5%) Operational Standards (93%) Cancer waiting times: 62-day standard 9 8 62-day wait for first treatment for all cancers, year to Sep 17 75.8 84.9 81. 84.7 77.8 92.4 72.3 76.8 87.8 88.8 88.8 82.4 83.4 Same as operational standard Below operational standard atandard Above operational standard England (81.6%) Operational Standards (85%) CADEAS Alliance Data Pack by 18

Early Diagnosis (%) Rate per, Cancer incidence 8 Age-standardised incidence rate for all cancers, 15 664 667 643 644 595 5 585 578 597 596 561 566 Statistically worse than England England (5 per, population) Early diagnosis Cancer diagnosed at stage 1 or 2 as a proportion of all staged and unstaged cancers ( cancers only*), year to December 16 49.8 49.7.5 55.4 51.9 52.9 49.4 56.9 52.2 53.1 54.5 47.7 48.9 Statistically worse than England England (52.6%) * Invasive malignancies of breast, prostate, colorectal, lung, bladder, kidney, ovary and uterus, non-hodgkin lymphomas, and melanomas of skin CADEAS Alliance Data Pack by 19

Median number of days Cancers Staged (%) Cancers staged 9 8 84.3 Cancers staged ( cancers*), 15 89.4 9.1 9.6 87.4 86.3 83.5 86.7 86.1 86. 83.4 77.4 77.2 Statistically worse than England England (9.83%) * Invasive malignancies of breast, prostate, colorectal, lung, bladder, kidney, ovary and uterus, non-hodgkin lymphomas, and melanomas of skin Median waiting times: Colorectal cancer pathway 9 8 39 17 14 4 Median waiting times (days): Colorectal cancer pathway, 15 23 16 22 16 18 17 13 9 3 8 6 7 32 15 19 13 24 29 27 15 19 21 16 16 16 14 17 14 17 15 13 12 8 9 8 7 8 9 12 18 22 21 22 Referral to First Seen First Seen to Diagnosis Diagnosis to MDT MDT to Treatment CADEAS Alliance Data Pack by

Median number of days Median number of days Median waiting times: Lung cancer pathway Median waiting times (days): Lung cancer pathway, 15 21 17 19 16 15 7 13 9 12 13 14 19 16 12 11 11 8 6 9 24 1 28 21 16 22 15 16 8 12 12 15 9 13 11 8 14 6 6 12 14 12 Referral to First Seen First Seen to Diagnosis Diagnosis to MDT MDT to Treatment Median waiting times: Prostate cancer pathway 1 8 29 19 41 Median waiting times (days): Prostate cancer pathway, 15 13 21 19 24 35 13 33 33 29 31 23 44 21 19 19 29 8 8 8 11 11 11 12 12 12 15 23 17 38 21 19 45 21 14 14 9 29 28 47 Referral to First Seen First Seen to Diagnosis Diagnosis to MDT MDT to Treatment CADEAS Alliance Data Pack by 21

8. Annex: Data sources Indicator Year Source Cancer outcomes One-year cancer survival Under-75 mortality agestandardised rate Prevalence Patients overall rating of cancer care (case-mix adjusted) Patients followed up in 16 15 21 year prevalence 1995-15 patients who are alive on the 31st December 15 16 https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsoci alcare/conditionsanddiseases/bulletins/indexofcancersurvivalforclinicalc ommissioninggroupsinengland/adultsdiagnosedto15andfollowed upto16/relateddata Benchmark: England Extracted from CancerStats Benchmark: England http://www.ncin.org.uk/view?rid=3579 National Cancer Patient Experience Survey http://www.ncpes.co.uk/ Benchmark: Expected values Cancer pathway Screening uptake and coverage Two-week waiting time standard 62-day waiting time standard Cancers diagnosed through emergency presentation Routes to diagnosis (all malignant neoplasms) 16/17 Quarterly Q3 16/17 to Q2 17/18; Year to Q2 17/18 Quarterly Q3 16/17 to Q2 17/18; Year to Q2 17/18 Year to Q1 17 15 Incidence rate 15 Cancers diagnosed at stage 1 & 2 (note this is based on the IAF definition and includes data for tumours only) Cancers staged 15 Pathways (median times) 15 Year to Q3 16 Confidence interval based on Wilson method https://fingertips.phe.org.uk/profile/cancerservices Benchmark: England https://www.england.nhs.uk/statistics/statistical-work-areas/cancerwaiting-times/ Benchmark: Operational Standard https://www.england.nhs.uk/statistics/statistical-work-areas/cancerwaiting-times/ Benchmark: Operational Standard Confidence interval based on Wilson method http://www.ncin.org.uk/view?rid=358 Benchmark: England https://www.cancerdata.nhs.uk/routestodiagnosis Benchmark: England Extracted from CancerStats Benchmark: England Confidence interval based on Wilson method http://www.ncin.org.uk/view?rid=35 Benchmark: England Confidence interval based on Wilson method. Extracted from CAS Benchmark: England NCRAS analysis using CAS data, based on TSCT-NCRAS work, using the CWT field REFERRAL_DATE: http://www.ncin.org.uk/view?rid=3544 CADEAS Alliance Data Pack by 22